Approaching sustainable development through energy management, the case of Fongo Tongo, Cameroon

This work is aimed at defining a possible solution for sustainable energy development in the Menoua Department, West Cameroon. The purpose of the cooperation between ALA Milano Onlus and the Biomass Energy Efficiency Laboratory of the University of Modena and Reggio Emilia was to analyze the case study in order to propose a solution for energy production capable of meeting the needs of the Cameroonian society while also heading towards a sustainable development. Primary researches suggested that the most viable solution was to integrate the corn food processing with the gasification of the cobs. The thermo-conversion process was modeled with a black-box approach; the results of the model were further compared with the energy required for corn processing, therefore demonstrating the sustainability and virtuosity of the chosen solution. A commercial 20 kW$$_el$$el gasifier was selected for supplying electrical power to three central buildings: the city hall, the Chaufferie and the school. This solution is a security measure assuring continue power supply to these vital buildings. Furthermore, it will bind the relation between the rural and the city areas through the energy exchange process

Electrophysiological study of visual pathways in nevoid basal cell carcinoma syndrome patients

Introduction: Gorlin-Goltz syndrome (GGS) also known as nevoid basal cell carcinoma syndrome (NBCCS) is a complex rare genetic disorder characterized by a wide range of clinical and radiological manifestations. Ophthalmological alterations have always been reported, but no study on the eventual pattern visual evoked potentials (pVEPs) abnormalities has yet been published.Purpose: The purpose of the study was to evaluate the functionality of the optic pathways in a group of NBCCS patients through pattern reversal VEPs, after a thorough exclusion of subjects with preexisting ocular and optic pathways pathologies.Methods: Nineteen NBCCS patients (31 eyes) and 20 healthy controls (40 eyes) have been recruited for this study. All subjects underwent an evaluation of the functionality of the optic pathways through pVEPs with small (120'), medium (60'), and large (15') check size stimulation.Results: NBCCS patients showed a statistically significant alteration in the transmission of the macular pathway function when compared to controls. PVEPs analysis confirmed a reduced amplitude and an increased latency of the P100 component, suggesting an involvement of the visual pathway even in the absence of ocular clinical manifestations.Conclusion: Visual pathways may have been affected both by a subclinical myelination deficit, determined directly by the genetic alteration, as well as by neurological abnormalities typical of this syndrome. Further studies are warranted

Citicoline in Ophthalmological Neurodegenerative Disease: A Comprehensive Review

Cytidine 5'-diphosphocholine has been widely studied in systemic neurodegenerative diseases, like Alzheimer's disease, Parkinson's disease, and brain ischemia. The rationale for the use of citicoline in ophthalmological neurodegenerative diseases, including glaucoma, anterior ischemic optic neuropathy, and diabetic retinopathy, is founded on its multifactorial mechanism of action and the involvement in several metabolic pathways, including phospholipid homeostasis, mitochondrial dynamics, as well as cholinergic and dopaminergic transmission, all being involved in the complexity of the visual transmission. This narrative review is aimed at reporting both pre-clinical data regarding the involvement of citicoline in such metabolic pathways (including new insights about its role in the intracellular proteostasis through an interaction with the proteasome) and its effects on clinical psychophysical, electrophysiological, and morphological outcomes following its use in ophthalmological neurodegenerative diseases (including the results of the most recent prospective randomized clinical trials)

A real‐world comparison among third‐generation antiseizure medications: Results from the COMPARE study

Objective: There are few comparative data on the third-generation antiseizure medications (ASMs). We aimed to assess and compare the effectiveness of brivaracetam (BRV), eslicarbazepine acetate (ESL), lacosamide (LCM), and perampanel (PER) in people with epilepsy (PWE). Efficacy and tolerability were compared as secondary objectives.Methods: This multicenter, retrospective study collected data from 22 Italian neurology/epilepsy centers. All adult PWE who started add-on treatment with one of the studied ASMs between January 2018 and October 2021 were included. Retention rate was established as effectiveness measure and described using Kaplan-Meier curves and the best fitting survival model. The responder status and the occurrence of adverse events (AEs) were used to evaluate efficacy and safety, respectively. The odds of AEs and drug efficacy were estimated by two multilevel logistic models.Results: A total of 960 patients (52.92% females, median age = 43 years) met the inclusion criteria. They mainly suffered from structural epilepsy (52.29%) with monthly (46.2%) focal seizures (69.58%). Compared with LCM, all the studied ASMs had a higher dropout risk, statistically significant in the BRV levetiracetam (LEV)-na & iuml;ve (hazard ratio [HR] = 1.97, 95% confidence interval [CI] = 1.17-3.29) and PER groups (HR = 1.64, 95% CI = 1.06-2.55). Women were at higher risk of discontinuing ESL (HR = 5.33, 95% CI = 1.71-16.61), as well as PER-treated patients with unknown epilepsy etiology versus those with structural etiology (HR = 1.74, 95% CI = 1.05-2.88). BRV with prior LEV therapy showed lower odds of efficacy (odds ratio [OR] = .08, 95% CI = .01-.48) versus LCM, whereas a higher efficacy was observed in women treated with BRV and LEV-na & iuml;ve (OR = 10.32, 95% CI = 1.55-68.78) versus men. PER (OR = 6.93, 95% CI = 3.32-14.44) and BRV in LEV-na & iuml;ve patients (OR = 6.80, 95% CI = 2.64-17.52) had a higher chance of AEs than LCM.Significance: Comparative evidence from real-world studies may help clinicians to tailor treatments according to patients' demographic and clinical characteristics

Characteristics and patterns of care of endometrial cancer before and during COVID-19 pandemic

Objective: Coronavirus disease 2019 (COVID-19) outbreak has correlated with the disruption of screening activities and diagnostic assessments. Endometrial cancer (EC) is one of the most common gynecological malignancies and it is often detected at an early stage, because it frequently produces symptoms. Here, we aim to investigate the impact of COVID-19 outbreak on patterns of presentation and treatment of EC patients. Methods: This is a retrospective study involving 54 centers in Italy. We evaluated patterns of presentation and treatment of EC patients before (period 1: March 1, 2019 to February 29, 2020) and during (period 2: April 1, 2020 to March 31, 2021) the COVID-19 outbreak. Results: Medical records of 5,164 EC patients have been retrieved: 2,718 and 2,446 women treated in period 1 and period 2, respectively. Surgery was the mainstay of treatment in both periods (p=0.356). Nodal assessment was omitted in 689 (27.3%) and 484 (21.2%) patients treated in period 1 and 2, respectively (p<0.001). While, the prevalence of patients undergoing sentinel node mapping (with or without backup lymphadenectomy) has increased during the COVID-19 pandemic (46.7% in period 1 vs. 52.8% in period 2; p<0.001). Overall, 1,280 (50.4%) and 1,021 (44.7%) patients had no adjuvant therapy in period 1 and 2, respectively (p<0.001). Adjuvant therapy use has increased during COVID-19 pandemic (p<0.001). Conclusion: Our data suggest that the COVID-19 pandemic had a significant impact on the characteristics and patterns of care of EC patients. These findings highlight the need to implement healthcare services during the pandemic

Practice patterns and 90-day treatment-related morbidity in early-stage cervical cancer

To evaluate the impact of the Laparoscopic Approach to Cervical Cancer (LACC) Trial on patterns of care and surgery-related morbidity in early-stage cervical cancer

STUDIO DELL’ASSE IGF-1/IGFBP-3 NEI PAZIENTI AFFETTI DA NEUROFIBROMATOSI DI TIPO I

La Neurofibromatosi di tipo I (NF1), anche chiamata “malattia di von Recklinghausen” o “neurofibromatosi periferica” o “multipla”, è la più comune forma di neurofibromatosi con un’incidenza di 1 su 2500 - 3500 nati. E’ una malattia a trasmissione autosomica dominante a penetranza completa, età-dipendente ed espressività estremamente variabile, anche all’interno della stessa famiglia. Il gene coinvolto codifica per la neurofibromina, una GAP-like protein essenziale per la regolazione negativa di Ras che agisce da oncosoppressore, esercitando fisiologicamente un controllo negativo sulla disponibilità di Ras attivato e quindi sulla proliferazione cellulare. La NF1 è una condizione multisistemica che coinvolge una varietà di tessuti e tipi cellulari; le caratteristiche cliniche maggiori riguardano alterazioni della pigmentazione cutanea e una vasta varietà di anomalie a livello del sistema nervoso centrale e/o periferico che possono evolvere in tumori benigni (come i neurofibromi) o maligni. L’analisi comparativa tra tipo/sede di mutazione e fenotipo non consente di individuare una precisa correlazione tra genotipo e quadro clinico nei pazienti affetti. Questa estrema variabilità fenotipica non è quindi spiegabile attraverso il semplice meccanismo di mutazione/delezione del gene. Anche se sono state formulate numerose ipotesi, non sono ancora noti i meccanismi molecolari che sottendono tale variabilità. Nella formazione e sviluppo dei neurofibromi, un ruolo chiave può essere svolto dai fattori di crescita. I tumori esprimono e secernono una varietà di fattori mitogeni e dei loro recettori che possono essere osservati nel siero dei pazienti. Una loro disregolazione è stata ipotizzata come possibile meccanismo nella patogenesi dei neurofibromi. Da questo presupposto è stato svolto un lavoro di analisi dell’espressione dell’asse IGF-1/IGFBP-3 nei pazienti affetti da NF1 comparando i livelli di concentrazione sierica di IGF-1 e IGFBP-3 in pazienti affetti con caratteristiche fenotipiche differenti di malattia rispetto ai controlli sani ed analizzando l’espressione recettoriale di IGF-1R su diversi tipi istologici di neurofibromi. I livelli sierici di IGFBP-3 sono ridotti nei pazienti NF1ed i bassi dosaggi della proteina sono inversamente proporzionali alla massa tumorale totale. Le concentrazioni di IGF-1 sono sovrapponibili nei gruppi considerati, tuttavia negli affetti IGF-1 circola meno legato alla sua proteina di legame, è biologicamente più attivo e può essere in grado di svolgere maggiormente i suoi effetti mitogeni a livello cellulare, potendosi legare sul recettore per IGF-1 espresso nella maggior parte dei neurofibromi. Pertanto la via IGF-1/IGF-1BP-3 può essere considerata nella catena di eventi molecolari che sono alla base dello sviluppo dei neurofibromi nei pazienti affetti da NF

Le linee guida del D.lgs.15 marzo 2010, 44 ("Decreto Romani")

L’articolo analizza le numerose novità introdotte con il recepimento della Direttiva 65/07 e le conseguenze dell’abbandono della nozione di “televisione” per quella di “servizio media audiovisivo” soprattutto nella prospettiva della convergenza tecnologica.

Molluscum contagiosum on a tattoo: usefulness of dermoscopy

[No abstract available